Changing Trends in Liver Transplantation: Challenges and Solutions.
Transplantation
; 105(4): 743-756, 2021 04 01.
Article
in En
| MEDLINE
| ID: mdl-32910093
ABSTRACT
Despite improvements in postliver transplant outcomes through refinements in perioperative management and surgical techniques, several changing trends in liver transplantation have presented challenges. Mortality on the waitlist remains high. In the United States, Europe, and the United Kingdom, there is an increasing need for liver transplantation, primarily as a result of increased incidence of nonalcoholic steatohepatitis-related cirrhosis and cancer indications. Meanwhile, donor suitability has decreased, as donors are often older and have more comorbidities. Despite a mismatch between organ need and availability, many organs are discarded. Notwithstanding this, many solutions have been developed to overcome these challenges. Innovative techniques in allograft preservation, viability assessment, and reconditioning have allowed the use of suboptimal organs with adequate results. Refinements in surgical procedures, including live donor liver transplantations, have increased the organ pool and are decreasing the time and mortality on the waitlist. Despite many challenges, a similar number of solutions and prospects are on the horizon. This review seeks to explore the changing trends and challenges in liver transplantation and highlight possible solutions and future directions.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Tissue Donors
/
Tissue and Organ Procurement
/
Liver Transplantation
Type of study:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Sysrev_observational_studies
Limits:
Humans
Language:
En
Journal:
Transplantation
Year:
2021
Document type:
Article
Affiliation country:
Canada